Provider Demographics
NPI:1750875712
Name:ANIMIKWAM, FRANK (MD)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:
Last Name:ANIMIKWAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1260 AJIJAAK AVE
Mailing Address - Street 2:
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770-8330
Mailing Address - Country:US
Mailing Address - Phone:231-242-1700
Mailing Address - Fax:231-242-1717
Practice Address - Street 1:1260 AJIJAAK AVE
Practice Address - Street 2:
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-8330
Practice Address - Country:US
Practice Address - Phone:231-242-1700
Practice Address - Fax:231-242-1717
Is Sole Proprietor?:No
Enumeration Date:2018-06-21
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5315091721207Q00000X
MI4301114806207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine